Please note: If you have a promotional code you'll be prompted to enter it prior to confirming your order.

Customer Sign In

Returning Customer

If you have an account, please sign in.

New Customers

If you subscribe to any of our print newsletters and have never activated your online account, please activate your account below for online access. By activating your account, you will create a login and password. You only need to activate your account once.

In Case You Missed It:

Food-borne illnesses, Part I: The big picture

Peanuts and peppers, hamburgers and spinach, chicken and cheese,
even cookie dough. Nearly every week, it seems, there's another
scare about contaminated foods and the epidemics that result.
What's gone wrong with America's food supply? And what can we do,
as individuals and as a society, to be sure our food is safe and
healthful?

Then and now

Although food-borne illnesses are a major worry today, the
problem is far from new. Just 100 years ago, in fact, large
numbers of Americans were contracting tuberculosis from
contaminated milk, typhoid fever and cholera from tainted water,
and trichinosis from infected meat. These life-threatening
problems have been all but eliminated, thanks to pasteurization
of milk, improvements in canning and refrigeration, better
sanitation, and disinfection of water supplies. Despite all this
progress, food-borne illnesses have stayed with us, and in recent
decades, the problem has taken on new dimensions.

Many factors contribute to the renewed concern about food safety.
Agriculture and food processing have grown enormously in scale,
and foods are shipped large distances within the U.S. — and into
the U.S. from around the world. Contamination in one place can
produce illnesses at great remove, making it difficult to
recognize an outbreak quickly and even harder to track down its
source. Large-scale ranching and farming practices mean that
animals are often crowded together, so harmful bacteria can
spread quickly. Because antibiotics are routinely added to animal
feed, these bacteria are increasingly drug-resistant. As eating
habits change, Americans are dining at restaurants more often,
thus losing control over food handling and preparation. As our
population ages, there are more elderly and chronically ill
individuals who are particularly susceptible to food-borne
infections. And just when we need help the most, the nation's
food safety agencies are underfunded, fragmented, and
overwhelmed.

Fortunately, these issues haven't brought back botulism and
cholera. But they have resulted in some 76 million food-borne
infections in the U.S. each year, 350,000 of which are serious
enough to require hospitalization and 5,000 of which are lethal.
And food-borne illnesses add $7 billion to America's annual
health care costs just when we can afford it least.

Infection or intoxication?

There are two major types of food-borne illnesses.

"Food poisoning" sounds fearsome, but, except for the rare case
of botulism, it's actually the milder problem. In this scenario,
food becomes contaminated by a bacterial pathogen, usually a
Staphylococcus, Clostridium, or
Bacillus species. The bacteria produce a toxin, which
remains in the food. Subsequently, cooking knocks off the
bacteria without destroying the toxin. People who eat food laced
with the toxin develop cramps and diarrhea within six to 12
hours, sometimes with vomiting. It can feel miserable and may
produce dehydration, but food poisoning never causes fever or
intestinal bleeding, and the symptoms resolve on their own within
a day or so. Because the illness is triggered by a toxin, not
living bacteria, food poisoning is an intoxication, not a true
infection.

Food-borne infections are more serious because contaminated foods
contain live microbes, which multiply within the patient's
intestines and can sometimes invade the bloodstream and spread to
other organs. In addition to cramps and diarrhea, victims often
have fever, and they sometimes develop complications in other
organs. Most food-borne infections remain confined to the
intestinal tract, and most resolve without antibiotics in less
than a week. Still, very serious infections can occur, and they
require serious treatment.

Good bugs, bad bugs

The human intestinal tract is home to 10 times more bacterial
cells than there are human cells in the entire body. There are up
to 1,000 species of bacteria in the colon; most are harmless, and
some can actually help preserve good health by breaking down
harmful chemicals, producing vitamin K, and crowding out
dangerous bacteria.

We live in harmony with our 100 trillion intestinal bacteria
because they're our bugs, and we're used to them. But one man's
friend can be another's foe. Sometimes the foes live in another
person's intestines, but more often they reside in the innards of
cattle, poultry, and other animals. Fruits, vegetables, nuts, and
other products can be contaminated by animal or human manure
right in the field or at any time in the long chain that leads
from farm to table. Meat and poultry can also be contaminated in
the slaughterhouse, and since ground beef and sausage contain
meat from many animals that is mixed together during processing,
a single episode of contamination can spread widely.

The inside job

When you ingest a preformed toxin, it goes to work at once;
that's why food poisoning starts so soon after you down the
contaminated chow. But food-borne infections don't cause any
symptoms for one to seven days. During this incubation period,
the bacteria set up shop in the intestinal tract As the bad guys
grow and multiply, they produce toxins and other harmful
products. When enough have accumulated, they rough up the
intestinal lining, causing cramps, fever, and diarrhea, which may
be bloody. That's bad enough, but if some bacteria sneak into the
bloodstream, dire problems can develop. Fortunately, this is
uncommon, and, in most cases, the body can recover on its own,
usually in about three to five days.

Fighting back

The body has several ways to check food-borne microbes. Stomach
acid and the digestive enzymes that break down food into
nutrients can kill some bacteria, particularly if the food is
lightly contaminated. The immune system can produce antibodies
and mobilize white blood cells that target bacteria, though the
process is slow. Bacteria that sneak into the bloodstream can be
filtered out by the liver and spleen and gobbled up by white
blood cells, limiting harm. And even the diarrhea that's so very
unpleasant can serve a useful purpose by expelling microbes and
their nasty products from the body. That's why doctors discourage
the use of antidiarrheal medicine for bacterial infections,
making exceptions for severe symptoms with dehydration.
Similarly, it's usually better to let your body control the
infection on its own, but doctors will prescribe antibiotics for
patients with severe symptoms or complications. Patients with
impaired immune systems are likely to need antibiotics; the very
young and very old are also highly vulnerable to food-borne
infections.

Prevention is, of course, the best way to fight back. That means
enhanced efforts by agriculture, industry, and government to
establish and enforce food safety standards and to inspect and
test foods before they reach your plate. And you can help, too,
by following simple precautions for storing, handling, and
preparing food.

Prevention: Food safety reform

It's important for all of us to shop wisely and to handle food
safely at home. But for full protection, we have to be sure food
is safe when it arrives at the market. That means preventing
microbial contamination, and it also requires weeding out
chemical contaminants, ranging from unsafe levels of pesticides,
antibiotics, and hormones to adulterants such as the melamine
that tainted the food supply in China in 2007.

The USDA is responsible for the safety of meat, poultry, and
processed eggs, while the FDA supervises most other foods. But
between 2003 and 2007, the FDA division that shoulders most of
the load shed 600 inspectors and 20% of its scientists. Thirteen
other federal agencies, operating under 30 different laws, are
also in the mix. It's a patchwork system with plenty of gaps.
It's also severely under-resourced and ill-equipped for the
globalization of our food supply and the threat of bioterrorism.
In fact, although we now rely on imports for 15% of our food
supply (including 60% of our fruits and vegetables and 75% of our
seafood), just 1% of our food imports are inspected.

We need federal, state, and local government reform, and we also
need the full cooperation of the private sector, including
importers, farmers, ranchers, and the food processing industry.
It's a tall order; to make it happen, we'll all have to do our
part as informed, active consumers and voters. And we also need
to consider new approaches that can help.

Prevention: Food irradiation

With so much worry about our food supply, you'd think we'd be
doing everything in our power to prevent food-borne infections.
But we're not. There are many ways to improve the situation; some
will require major reforms by the private sector and government,
but one of the most helpful is ready to go. It doesn't require
new technology or expensive research. But it does require a new
mindset, since many consumers are scared off by its name:
irradiation.

Pasteurization kills bacteria in food with energy from heat;
irradiation kills microbes with energy from ionizing radiation.
The energy can be generated in the form of electron beams,
x-rays, or gamma rays. The process is quick and does not raise
the food's temperature. The energy passes right through the food,
and the food that emerges is not radioactive, any more
than you are radioactive after you have a chest x-ray or CT scan.
And irradiated food retains its appearance, flavor, and
nutritional value.

Food irradiation has been in use for decades. It is approved in
over 40 countries, and extensive experience with animals and
people (including American astronauts) who have eaten irradiated
food has not revealed any increased risk of cancer or other
health problems.

Many government agencies and independent organizations have
endorsed food irradiation. The list includes the FDA, CDC,
Department of Agriculture, American Dietetic Association,
American Academy of Pediatrics, and the World Health
Organization. In the U.S., irradiation is approved for herbs and
spices, meat and poultry, fruits, vegetables and seeds, eggs, and
wheat. Even so, only 10% of our herbs and spices and just 0.002%
of our other foods are irradiated. Ironically, perhaps, many
medical supplies — from bandages to implanted devices — are
sterilized by irradiation without triggering any consumer
protests.

Irradiated food won't budge the meter on a Geiger counter, but it
sets the dial spinning on talk radio. Consumers should have their
say, and they'll always have the freedom to choose since all
irradiated foods are labeled as such. Packages also bear the
universal symbol for irradiation, the radura (pictured here).

Food irradiation is not a cure-all; even if it were widely
adopted in the U.S., we'd still need all the other steps to
improve food safety. Still, the CDC estimates that if food
irradiation were used for just half the meat and poultry consumed
in the U.S., we'd eliminate 900,000 cases of food-borne illnesses
and prevent 352 deaths in a year. Perhaps warning labels should
be affixed to food that has not been sterilized by
irradiation.

Best-selling Reports

Harvard Health Minute

Men and depression: Getting the right treatment

Daily Health Tip

Don't snack late at night

If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option.